Provider Demographics
NPI:1679975049
Name:VARMA, SOHAN R (MD)
Entity type:Individual
Prefix:
First Name:SOHAN
Middle Name:R
Last Name:VARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 959
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20172-0959
Mailing Address - Country:US
Mailing Address - Phone:703-436-9969
Mailing Address - Fax:703-574-5585
Practice Address - Street 1:4229 LAFAYETTE CENTER DR STE 1125B-1
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1261
Practice Address - Country:US
Practice Address - Phone:703-436-9969
Practice Address - Fax:703-574-5585
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101255924207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine